Many women encounter a quiet struggle, known as Vaginismus. It occurs when vaginal penetration, whether for sexual intercourse, using tampons or during a pelvic exam, leads to involuntary muscle spasms, discomfort or anxiety. In this article, we will delve into what Vaginismus is and why you should not ignore it.
What Is Vaginismus?
Vaginismus happens when the muscles surrounding the vagina tighten involuntarily, making penetration either painful or impossible. These spasms happen without your conscious control. Medically, it falls under the category of genito-pelvic pain/penetration disorder.
Women dealing with Vaginismus may feel this discomfort during attempts at sexual intercourse, while inserting a tampon, or during a pelvic exam. It is important to note that not all pain during penetration is Vaginismus; the key characteristic is the uncontrollable tightening of the vaginal muscles in response to attempts at penetration.
Types of Vaginismus
Vaginismus has different forms. Understanding these variations can help shape the treatment approach:
- Primary Vaginismus: This happens when penetration has always been painful or impossible right from the very first attempt, whether it is during intercourse or when trying to use a tampon.
- Secondary Vaginismus: In this case, penetration was once comfortable but later became painful or even impossible due to an event like trauma, childbirth or surgery.
There are also situational or context-specific types: sometimes spasm only occurs under certain circumstances. This is referred to as situational Vaginismus, while global Vaginismus applies when it happens in all situations.
What Causes Vaginismus?
Getting to the root causes of Vaginismus is crucial for effective treatment, as both physical and psychological factors often play a significant role.
Physical Contributors:
- Previous injuries or surgeries in the pelvic area.
- Infections, vaginal irritation, or other medical conditions (like urinary tract infections or vulvodynia).
- Scarring or trauma from childbirth or surgical procedures.
- Hormonal changes (such as those during menopause) can lead to reduced lubrication and increased discomfort.
Psychological & Emotional Factors:
- Fear of pain or anxiety surrounding vaginal penetration.
- Negative beliefs about sex or a challenging upbringing.
- A history of sexual trauma or abuse.
- Past experiences of painful intercourse have led to a fear that the pain will only get worse over time.
Often, a biopsychosocial approach is needed, which means addressing both emotional and physical factors together.
Symptoms and Early Signs of Vaginismus
Understanding the symptoms and early signs of Vaginismus is crucial for catching the condition early on.
Symptoms of Vaginismus:
- Involuntary tightening or spasms of the vaginal or pelvic muscles.
- Experiencing pain, burning, or stinging during attempts at vaginal penetration.
- Difficulty or an inability to engage in intercourse, use tampons, or undergo pelvic exams.
- Feelings of anxiety, fear, or tension surrounding any attempt at penetration.
- A noticeable decline in sexual intimacy or a tendency to avoid intimate situations.
Early Signs:
- Hesitating to use tampons or having trouble with insertion.
- Feeling anxious about gynaecological exams.
- Experiencing stiffness or contractions before intercourse even starts.
These early signs can show up before the symptoms of Vaginismus and recognising them sooner can be beneficial to get earlier intervention.
Diagnosis & Assessment for Vaginismus
When diagnosing Vaginismus, a healthcare provider will:
- Gather a comprehensive history, including sexual history, when symptoms began and any past trauma.
- Perform a quick pelvic exam if possible, aiming to rule out other potential causes of pain, like infections or anatomical issues.
- Assess muscle tone and possibly use biofeedback to evaluate the activity of the pelvic floor muscles.
- Eliminate other medical conditions that could mimic Vaginismus, such as vulvodynia, vaginal atrophy, infections, or structural abnormalities.
Women experiencing Vaginismus may feel hesitant during pelvic exams, so it is vital to approach the situation with clear communication and sensitivity.
Vaginismus Treatment Options
Treating Vaginismus requires a comprehensive approach. This combines physical, psychological, and medical strategies to tackle the issue from all angles.
- Pelvic Floor Physical Therapy: A skilled therapist will guide you in relaxing your pelvic floor muscles, easing tension, stretching, and gradually using vaginal dilators.
- Vaginal Dilator Training: This involves slowly introducing dilators of increasing sizes to help desensitise the muscles.
- Psychotherapy / CBT: These therapies focus on addressing any anxiety, fears, or beliefs surrounding sex; while also helping you develop effective coping strategies.
- Couples / Sexual Education Therapy: Involving your partner(s) can enhance communication, intimacy, and alleviate performance pressure.
Throughout the treatment process, it is essential to be patient, recognise gradual progress, and seek support. Remember, there’s no universal solution that fits everyone.
When & Why to Seek Help
You should think about reaching out to a specialist if:
- Any attempt at vaginal penetration is painful or feels impossible.
- The condition is causing emotional distress, straining your relationships, or leading to sexual avoidance.
- You start to notice early signs, like discomfort with tampons or during exams.
- You want to maintain your sexual health and intimacy without unnecessary delays.
Getting help early on usually leads to better outcomes, helping to prevent the fear cycle from escalating.
Wrapping Up
Vaginismus is not something you should blame yourself for. It is a condition that can be treated. By taking the right steps, you can find a way back to comfort and intimacy. You do not have to endure pain or anxiety any longer.
If you are experiencing vaginal discomfort or difficulty with penetration, do not hesitate to contact Motherhood IVF. Our compassionate gynaecologists and sexual health specialists are here to help you on your journey to healing and renewed confidence.
Frequently Asked Questions about Vaginismus
Can Vaginismus be cured?
Vaginismus can be cured through physical therapy, fertility counselling and dilation techniques. While more severe cases might take a bit longer, they often respond well to personalised treatment plans.
How long does Vaginismus treatment take?
The duration depends on how severe the condition is and how each individual responds. Some individuals may see improvements in just a few weeks, while others might need several months.
Is Vaginismus psychological or physical?
It is a mix of both. Vaginismus involves involuntary muscle spasms, which are physical, but these spasms can be triggered or sustained by psychological factors like fear, anxiety and past experiences.
Are dilators painful during Vaginismus treatment?
They might cause a bit of mild discomfort at first, but they are specifically designed to be pain-free when used gradually and with the right technique, lubrication, and relaxation.